Hospital Care and Surgical Treatment of Children With Congenital Upper Limb Defects

Abstract

Background and Aims: To evaluate hospital care of children with congenital upper limb defects. Materials and Methods: Three hundred and sixty-two children with an upper limb defect, born 1993–2005, and alive after birth admission were identified in the Finnish Register of Congenital Malformations. The data on hospital care, with focus on operative treatment, were collected from the National Hospital Discharge Register, until 31 December 2009. Mean follow-up was 10.2 years (range: 4–17 years). The results were compared with data on the whole children population (1.1 million) in Finland. Results: Most children (321, 87%) with upper limb defects had hospital admissions: on average, one admission/year (range: 0–36), and they were treated in hospital 5 days/year (range: 0–150), which is 11-fold compared with an average child in Finland. Four surgical procedures/child were done (range: 0–45), including one hand surgical procedure. The most common procedures were orthopedic (513); gastrointestinal (263); ear, nose, and throat (143); dental (118); thoracic (48); and urologic (44). Of the 513 orthopedic procedures, 326 were directed to upper limbs, 107 to the lower limbs, and 10 to the spine. Median operation age was 2 years 7 months. Altogether, 60% of hospital admissions were non-surgical. Leading causes of non-operative hospital admissions were congenital anomalies (32%), gastroenterological problems (20%), respiratory tract conditions (13%), neurological problems (7%), perinatal conditions (5%), and infectious diseases (5%). Conclusion: Treatment of children with upper limb defects is teamwork between pediatric and surgical subspecialties. Burden of hospital care is 11-fold as compared with an average child.

Needs and challenges as perceived by mothers and their hospitalized children having congenital anomalies

“…In relation to financial responsibility, the mothers' challenges had higher mean score was 1.19±.314. This result corresponds with [31] they concluded that the financial burden of hospital care among children with CA has an effect on all family members, specifically with number of admissions and total time spent in hospital. The researcher's point of view the financial challenges were the main element during the treatment process for children and had a negative impact on all family members On the other hands, mothers' challenges had higher mean score for health team communication (1.37±.485).…”

Prune belly syndrome in Finland – A population-based study on current epidemiology and hospital admissions

“…Multiple miscarriages emerged as the only significantly associated risk factor to PBS in our analyses. During 1993e2005, children in Finland had on average 0.09 admissions per year with on average of 0.4 days spent in hospital per year which is greatly surpassed by the admissions and days spent in hospital for the PBS patients (p Z 0.001) [15]. Our results highlight the burden of disease measured through health care usage, which is many-fold compared to children in Finland in general [15,16].…”

Factors affecting hand cosmesis and the aesthetic impact of surgery on congenital hand differences in Finland

“…The reported incidence of upper limb deficiencies is 5-20 per 10,000 births (Ekblom et al, 2010;Giele et al, 2001;Koskimies et al, 2011). In Scandinavia 30-50% of children born with an upper limb difference were treated surgically (Koskimies-Virta et al, 2020;Ekblom et al, 2010), with the most common surgical procedures being removal of supernumerary digits and syndactyly separation (Koskimies-Virta et al, 2019). Surgery is ideally performed during the first years of life but almost always before school age (Koskimies-Virta et al, 2019).…”